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2016 ; 20
(4
): 15-222
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English Wikipedia
Anal Health Care Basics
#MMPMID27723447
Chang J
; Mclemore E
; Tejirian T
Perm J
2016[Fal]; 20
(4
): 15-222
PMID27723447
show ga
Despite the fact that countless patients suffer from anal problems, there tends
to be a lack of understanding of anal health care. Unfortunately, this leads to
incorrect diagnoses and treatments. When treating a patient with an anal
complaint, the primary goals are to first diagnose the etiology of the symptoms
correctly, then to provide an effective and appropriate treatment strategy.The
first step in this process is to take an accurate history and physical
examination. Specific questions include details about bowel habits, anal hygiene,
and fiber supplementation. Specific components of the physical examination
include an external anal examination, a digital rectal examination, and anoscopy
if appropriate.Common diagnoses include pruritus ani, anal fissures, hemorrhoids,
anal abscess or fistula, fecal incontinence, and anal skin tags. However, each
problem presents differently and requires a different approach for management. It
is of paramount importance that the correct diagnosis is reached. Common errors
include an inaccurate diagnosis of hemorrhoids when other pathology is present
and subsequent treatment with a steroid product, which is harmful to the anal
area.Most of these problems can be avoided by improving bowel habits. Adequate
fiber intake with 30 g to 40 g daily is important for many reasons, including
improving the quality of stool and preventing colorectal and anal diseases.In
this Special Report, we provide an overview of commonly encountered anal
problems, their presentation, initial treatment options, and recommendations for
referral to specialists.
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